Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The real value of high-value care

Julia Canick and Walter Lee, MD, MHS
Policy
January 18, 2022
Share
Tweet
Share

When newly admitted medical students enroll in their respective programs, they participate in the cherished White Coat Ceremony, in which they eagerly vow to stop at nothing to help patients—to go above and beyond to provide the highest quality care to any and every individual who needs it. Though this aspiration is not overtly naïve, it is, perhaps, exceedingly optimistic. As training progresses, many students come to realize that the “best” care is not always the most accessible, and often does not make the most sense (from both financial and diagnostic standpoints). Medical school curriculums emphasize the consideration of “cost-effective care”—diagnostics and treatments that meet the necessary standards of care without spending unnecessary dollars. This approach certainly makes sense; after all, few physicians would find it sensible to order a costly MRI for a patient whose diagnosis is already obvious without it. However, this framework takes for granted a notion that, perhaps, deserves some thoughtful inquiry: how has our society so readily put a price on different tests and treatments—and, by extension, on life?

Of course, much of these costs stem from the prices of labor, materials, and expertise. However, we rarely wrestle with the underlying unease that comes with the fact of how we have put prices on any of these services at all. This is no one’s fault; there is a fundamental tension between limited health care resources and the priceless value of human life—a tension that no amount of wealth or means can overcome. The medical system is such that there can exist a contradiction between the care that is indicated and the care that would be most cost-effective; we want the best care for our patients, but do not have unlimited financial resources. How, then, do we forgive ourselves for placing a numerical valuation on the health requirements of others? After all, we are merely human—yet we must appraise the needs of our equally human patients.

Perhaps the beginning to this answer starts with recognizing that “value” is not solely a monetary term. High-value care might be sparing an exhausted elderly patient another battery of tests for a few more days, regardless of whether the results will change her medical management. It might be taking the extra time to look at a bump on a teenager’s arm, to ease his anxiety. It might be taking a patient’s perspective into account, and ordering the specific test he is asking for. In any respect, shifting the idea of “value” from a purely pecuniary definition to a more comprehensive one permits a more holistic notion of what is meant by “high-value care.”  If we do only numerical calculations, our valuation is limited; we will do our patients justice only when we consider more than the financial.

Spending extra time with patients, getting to know them, and understanding their perspectives has been repeatedly shown to improve outcomes and build patient trust. What we have not considered, however, is the notion that these extra efforts might also have profound effects on the doctors who practice them. Approaching “value” as a multi-faceted entity—one whose definition differs for every single patient—is a personalized way to humanize the often “routine” practice of medicine. This view might help doctors, especially those in training, cope with the fact that different patients have different goals and be more understanding of questions and requests that are less traditional; it could encourage physicians to become more invested in patient care and redefine their conceptualizations of success.

Without a doubt, it is uncomfortable to consider high-value care from a monetary standpoint; it is unpleasant to ration resources and indirectly assign non-arbitrary values to human lives. This is one of the fundamental challenges of medicine. This profession has the capacity to save lives, but currently does so with great inequity. This task becomes less monstrous when we realize that, at the end of it all, we have the duty not to prolong life or protect funds at all costs, but to empower patients to achieve outcomes consistent with the World Health Organization’s definition of health: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Medical schools can plant these seeds early: curricular inclusion of teaching about financial toxicity—the term to describe problems that patients face related to the burden of payment— along with teaching about shared decision-making around individual values and goals have the potential to shape physician engagement with individuals who might need extra support3. And while clinicians can do right by their patients by being conscious of costs, they can do even better by including other, non-monetary components in the value calculation of what determines whether care is “worth it.”

Julia Canick is a medical student. Walter Lee is an otolaryngologist.

Image credit: Shutterstock.com

Prev

The painful anniversary of Dr. Susan Moore

January 18, 2022 Kevin 1
…
Next

It's time to rethink board recertification

January 18, 2022 Kevin 12
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
The painful anniversary of Dr. Susan Moore
Next Post >
It's time to rethink board recertification

Related Posts

  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • A real-life example of irrational health care spending

    Taylor J. Christensen, MD
  • Why health care replaced physician care

    Michael Weiss, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • Got real rights? Not when seeking health care.              

    John T. James, PhD and Michael F. Mascia, MD, MPH
  • Care is no longer personal. Care is political.

    Eva Kittay, PhD

More in Policy

  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • The untold story of Hispanic/Latino health: Why subgroup data matters

    Matthew B. Alonso
  • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

    Osmund Agbo, MD
  • Family physicians unite at the U.S. Capitol, seeking congressional support for Medicare reform and health care transformation

    Tochi Iroku-Malize, MD, MPH, MBA, Sterling N. Ransone, Jr., MD, and Steven P. Furr, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Catching the Optimal Amount of Z's May Be Protective Against Long COVID
  • Treating Early Hospitalization Blood Pressure Deemed a No-No for Patient Safety
  • Addressing Burnout in an Invisible Part of the Health Workforce
  • Family-Oriented Sedation Protocol Helps Kids With ASD Manage Routine Healthcare
  • Bariatric Surgery in Kids With Obesity Becoming More Common

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...